Description of Sexual Orientation and Sexual Behaviors among High School Girls in New York City.

STUDY OBJECTIVE: Examination of the association of sexual orientation to the sexual practices and health behaviors of high school girls in New York City (NYC).

DESIGN, SETTING, AND PARTICIPANTS: Data were drawn from the 2013 Youth Risk Behavior Surveillance System survey of public high school students in grades 9-12 in NYC.

INTERVENTIONS: None.

MAIN OUTCOME MEASURES: Independent variables included sexual orientation and gender of sexual partners. Dependent variables include sexual/health risk behaviors. We used t tests to compare mean ages and χ(2) tests to compare distributions according to sexual orientation, gender of sexual partners, and differences in risk behaviors.

RESULTS: The survey was completed by 4643 girls; mean age, 15.5 years; (1103 + 1842)/4254 (69%) black or Latina; 1101/4000 (27.5%) sexually active; 3574/4412 (81%) heterosexual; and (92 + 526)/4412 (14%) sexual minorities; 24.1% were heterosexual, 52.1% lesbian, and 49.4% were bisexual girls and were sexually active; 247 were classified as women who have sex with women (WSW) or WSW and men (WSWM). Of the sexually active girls, (65 + 182)/1081 (23%) were WSW/WSWM. The WSW/WSWM reported earlier sexual debut, more sexual partners, higher pregnancy rate, use of alcohol at last sex, history of intimate partner violence, and less likelihood of having an HIV test.

CONCLUSION: Almost one in four of sexually active high school girls in NYC can be classified as WSW, who are vulnerable to increased sexual and health risk-taking behaviors leading to adverse health outcomes. The discordance between sexual behavior and sexual orientation emphasizes the importance of the provider sharing protective strategies in the sexual health counseling session for their patients who engage in sex with female partners regardless of sexual orientation.